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Common Epidemiology of Rickettsia felis Infection and Malaria, Africa

2013; Centers for Disease Control and Prevention; Volume: 19; Issue: 11 Linguagem: Inglês

10.3201/eid1911.130361

1080-6059

Oleg Mediannikov, Cristina Socolovschi, Sophie Edouard, Florence Fenollar, Nadjet Mouffok, Hubert Bassène, Georges Diatta, Adama Tall, Hamidou Niangaly, Ogobara K. Doumbo, Jean Bernard Lékana-Douki, Abir Znazen, M’hammed Sarih, Pavel Ratmanov, Hervé Richet, Mamadou Ousmane Ndiath, Cheikh Sokhna, Philippe Parola, Didier Raoult,

Parasites and Host Interactions

Abstract This study aimed to compare the epidemiology of Rickettsia felis infection and malaria in France, North Africa, and sub-Saharan Africa and to identify a common vector. Blood specimens from 3,122 febrile patients and from 500 nonfebrile persons were analyzed for R. felis and Plasmodium spp. We observed a significant linear trend (p<0.0001) of increasing risk for R. felis infection. The risks were lowest in France, Tunisia, and Algeria (1%), and highest in rural Senegal (15%). Co-infections with R. felis and Plasmodium spp. and occurrences of R. felis relapses or reinfections were identified. This study demonstrates a correlation between malaria and R. felis infection regarding geographic distribution, seasonality, asymptomatic infections, and a potential vector. R. felis infection should be suspected in these geographical areas where malaria is endemic. Doxycycline chemoprophylaxis against malaria in travelers to sub-Saharan Africa also protects against rickettsioses; thus, empirical treatment strategies for febrile illness for travelers and residents in sub-Saharan Africa may require reevaluation.